Trusts spend a lot of time entering data to support National Clinical Audits (NCA). However, for those staff at the front line, the results are not always being fed back in an easily accessible and easy to use format. As a result, working with the CQC, HQIP developed National Clinical Audit Benchmarking (NCAB).

NCAB distills quality data on structure, process and outcome measures into a concise set of key metrics for each audit topic on a page, also showing trends over time. NCAB provides a visual snapshot of individual Trust or hospital audit data set against national benchmarks. This is a specialist tool aimed at key trust staff taking advantage of our positive working relationships with quality improvement and clinical audit leads as well as medical directors/clinical directors. Key staff are notified by email when data becomes available with links to view data sent straight to their inbox.

We would like to survey users on how we could improve the tool and then want to use this feedback (including feedback from the Q Community) to ensure that outputs enable quality improvement and shared learning. This would be achieved by providing and making data/information accessible to front line staff, clinical services and also trust boards through a number of mediums including an application on smartphone devices. We would then wish to share and capture the progress of the quality improvement (QI) work that the hospitals have engaged in to enable other teams to learn from these approaches.

Our Proposal

We wish to increase the use of national clinical audit data to drive QI at local, regional and national levels. We know that by the end of April 2018, 84% of the data sets had been accessed using the NCAB platform, equating to more than 1000 views. Some of the requests for improvement include the need to annotate the data and trends to enable QI messages/learning, links to QI case studies and results by regions. We want to develop the NCAB platform with the feedback we will collect via our survey and with the help of the Q Community. Some early ideas we have had for improvement is adding ‘tooltips’ functionality, which would aim to make associated and targeted QI messages more easily accessible by:

1.Highlighting sites/hospitals/Trusts performing well on a particular metric to encourage learning and sharing of best practice

2.Enhancing notification emails that update relevant staff to new data including key messages about their performance

3.Improving the use of data for other outputs such as NHS Trust annual quality account reports/communications and submissions

We also want to develop an app to make the NCAB platform accessible on smart phones in a convenient way. We know 10% of NCAB users are already accessing the platform via mobiles devices. We want to optimise the experience for our end users, as well as take advantage of the additional functionality available in this digital environment.

Benefits

Expected key outcomes:

more frontline staff frequently viewing the results of national clinical audit data enabling local discussions about process, structure and outcome measures that would benefit from quality improvement approaches as well as identification of services which are performing at high standards to enable learning and sharing of approaches

the formation of and input from a stakeholder and user group, which will include patients, staff and Q members to test, refine and facilitate our approach, app and outputs to evolve in an agile and dynamic way

more organisational leadership figures supporting or taking part in quality improvement activity

the quality of healthcare potentially improving in all domains (effectiveness, safety, efficiency, equality, timeliness and person centricity) which can be tracked over time and used for baseline measurement at local, regional and national levels accessible at your fingertips (via the app).

We will measure these outcomes through monitoring of the use of the website, app downloads, surveys of website and app users, as well as capturing case study evidence of actual care process changes that are likely to lead to improved outcomes for patients and services.

We hope the NCAB platform and its interoperability and interactivity will be a helpful one for many members of the Q Community within their host organisations, supporting to drive their local, regional and national QI efforts. That is why we need their feedback on how it can be improved in order to meet the needs of the end users. We will enable all Q community members to take part in giving feedback on the tool and testing it out as it develops. We would be delighted to blog about our progress and encourage real-time and dynamic feedback through various media channels.

Reviewer feedback

This is a great project because…

There is huge potential for making national clinical audit data more usable for those improving services and this project aims to make that data more accessible. It builds on an existing tool but plans to use feedback from the Q community and others to make it better. We liked the focus on making use of existing data to support change.

By the time of the event we encourage the project team to think more about…

One of the challenges will be finding out how the data and tool are being used to support change. We liked that the team want to understand end impact but thought they could further develop how they might achieve that.

Supporters

Amount requested

£30k

Idea themes

Quality improvement

Regulation

Analytics and data

Digital technology

Leadership

Idea locations

England – Yorkshire and Humber

England – West

England – West Midlands

England – Wessex

England – London (East, North and Essex)

England – East

England – South West

England – London (South)

England – Oxford

England – North West Coast

England – North East and North Cumbria

England – Kent, Surrey and Sussex

England – London (West)

England – Greater Manchester

England – East Midlands

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Comments

Thank you for your comment and question Simon. Several meetings have been held between GIRFT, Model Hospital and HQIP to enable joint working that is mutually beneficial which is underpinned by a jointly signed and agreed MOU. We fully support the sharing of national clinical audit (NCAPOP) data for secondary uses within the relevant information governance frameworks – collect it once, use many times and in this instance NCAPOP data is already supporting GIRFT and Model Hospital areas of interest. This proposal would further support this as it is the same data that Model Hospital and GIRFT already have access to. It is just cut (analysed) for a specific purpose in terms of metric selection and analysis to drive quality improvement and visualise data for end users such as medical directors and hospital inspectors from the CQC as just some examples.

Lots of mutual support opportunities with Making Data Count; lets chat! Also interested in how this could read across to/support/be a shining example to other areas of analysis (GIRFT/Right Care) as well as your thoughts on wider audiences?

Hey Mireck, great idea!
We (RCPQI) would be keen to work with you to develop ways to facilitate the use this data for QI, perhaps trialing it with some of your early adopters etc.
Good luck with the bid.

Hi Marina, thanks for your interest! The current plan is to firstly add all the suitable NCAs from the NCAPOP programme and then look elsewhere at other NCAS we can add to the platform. If you had any particular ones in mind let us know!

Really interesting project, I think the NCA data really needs to be used as much as possible to justify the sometimes very labourious lengths that trusts have to go to to obtain good quality data.
I think some agencies that are running the audits already have online visulisation tools that help you understand audit data, but I think your project holds more weight as it aligns with benchmarking and the CQC.
Certainly a great way to quickly see audit results across a number of audits. From experience it is quite difficult to find results of a particular trust in an annual report across a number of performance measures!

Thanks Kathleen. Making accessing the data as quick and easy as possible is our key aim here. As you say we know a number of audits are already producing great online visualisation tools, but by creating a one stop shop for easy access we can also act as a stepping stone to these tools and the fuller data on the audit website. Would be great to have you involved in the iterative testing and feedback on the app if you would like to be involved?

Hello. I work in South Tees Hospitals NHS FT and we'd be interesting in testing the app. I also have a regional role (North East and North Cumbria) so could encourage others if you are looking for more sites.

Congratulations for making it to the shortlist. Can you define a role for lay persons and expert patients in dissemination of data in support of Quality Improvement locally where we live? How could the HQIP Service User Network be mobilised to communicate productively in our communities and neighbourhoods such that an appetite for data driven Quality Improvement gets embedded in all Public and Patient Involvement efforts across the UK?

Hi Mirek
congrats on shortlist
we like the NCAB info graphic and are planning a pilot data visibility project of our NCAB data at GSTT
would be v keen to try out your App
Jonathon
Chair QI and Audit GSTT

Mirek, Data is most valuable when used for improvement if it can de linked to the process or processes that the data was generated from. I have been in discussion with NHS Improvements on how this can be achieved for the Model Hospital data. Does you project include any process mapping? Regards Tom

Hi Tom and thank you for your comment. Yes that is exactly where the data comes from, processes in the specific pathways. These are mapped across the pathway and also try to capture processes as recommended by NICE and or specific clinical standards too. There is however always a review period, at least yearly, and more process mapping may be indeed needed following these reviews.
Would be interested to know if the data for model hospital follows something similar and if not do you know what data sets are being used? Happy to connect help with some national data sets if useful?
Best WIshes
Mirek

Dear Q Members and Fellow Commentors,
I am contacting you in relation to our Q exchange project where we said we would seek the feedback of the Q members from the Q community. Our project seeks to use the Q Exchange (https://q.health.org.uk/idea/speed-dataing/) funding to make changes to the platform as a result of your feedback.
Why are we contacting you?
We are really excited to launch our survey to find out how we can improve our National Clinical Audit Benchmarking (NCAB) platform for users. Every month hundreds of users are using NCAB to access national clinical audit (NCA) data. Primarily these users are based at Acute Trusts working in the relevant specialties or in clinical and executive leadership positions or quality improvement leads and respective QI team members. These users are the focus of our attempts to seek feedback as an opportunity for improving the platform and site. We also welcome wider feedback from all Q community members interested in helping us shape this.
As such, we would welcome those with an interest in using data for improvement to complete our survey: https://www.surveymonkey.co.uk/r/3PKJLRYWhat is National Clinical Audit Benchmarking (NCAB)?
NCAB is an online portal providing access to national audit performance data. Its unique feature is that it brings together results from national audits in one platform so that the most recent results across the portfolio can be easily accessed and viewed by each healthcare provider. NCAB distils what can be necessarily extensive reporting into a concise set of key metrics for each audit topic. Results are presented in an easy to understand visual form, specific for each Trust, hospital and in some cases ward and where available against national benchmarks.
What if you have never used NCAB?
That is ok! The survey enables you to take a look at the website first via a link to enable you to see what it is like before you give your feedback. We think NCAB is most useful for clinical and executive leaders and improvement (QI, audit, clinical) leads at Acute Trusts but we welcome wider feedback including from patients and commissioners too!
When do I need to do it by?
It takes about 10 minutes to complete the survey. So why not do it now! But if you don’t have the chance right this minute, then you can still do it later and by 14th December if at all possible. We will send out a reminder that week.
We will publish anonymous results unless you leave your email and we contact you in relation to sharing your personal feedback.
Thanks again for your time
HQIP Q Exchange Team
Dr. Kieran Mullan
Audit Data for Improvement Lead, HQIP Kieran.mullan@hqip.org.uk,
HQIP Q Exchange Team Q members: Yvonne Silove Yvonne.Silove@hqip.org.uk and Mirek Skrypak Mirek.Skrypak@hqip.org.uk

UPDATE AND THANK YOU 22/01/2019
We wanted to update everyone that supported and was
interested in our project. We have now run a survey of users and those
interested in using NCAB to find out how they think we can improve the
platform.
We have had almost 100 responses and we have already
identified a number of positive changes we can implement from the most popular
ideas.
We will now be refining the feedback to finalise the list of
changes that we want to test out with our web development team.
We will continue to update and look forward to future discussions and collaboration.
Speed DATAing Q Exchnage HQIP Team